Provider Demographics
NPI:1922435353
Name:DIAZ MARTINEZ, MARIA D (MS, SLP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:DIAZ MARTINEZ
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND QUINTAVALLE
Mailing Address - Street 2:149 CALLE ACUARELA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3580
Mailing Address - Country:US
Mailing Address - Phone:787-448-2561
Mailing Address - Fax:
Practice Address - Street 1:COND QUINTAVALLE
Practice Address - Street 2:149 CALLE ACUARELA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-3580
Practice Address - Country:US
Practice Address - Phone:787-448-2561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003025-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist